Obesity and Prostate Cancer Aggressiveness among African and Caucasian Americans in a Population-Based Study

Abstract

Background: This study evaluated obesity and prostate cancer aggressiveness relationship in a populationbased incident prostate cancer study.Methods: The North Carolina-Louisiana Prostate Cancer Project includes medical records data for classification of prostate cancer aggressiveness at diagnosis by using clinical criteria for 1,049 African American (AA) and 1,083 Caucasian American (CA) participants. An association between prostate cancer aggressiveness and obesity, measured using body mass indices (BMI) and waist-to-hip ratio (WHR), was assessed using ORs and 95% CIs adjusted for confounders.Results: A significantly positive association was found between prostate cancer aggressiveness and obesity. The ORs for high aggressive prostate cancer among prediagnosis obese and severely obese were 1.48 (95% CI ¼ 1.02-2.16) and 1.98 (95% CI ¼ 1.31-2.97), respectively, compared with normal weight research subjects. Race-stratified results suggested the association is stronger among CAs. Interaction model showed that normal weight AAs had more aggressive prostate cancer than normal weight CAs (OR ¼ 2.69, 95% CI ¼ 1.36-5.30); severe obesity was associated with aggressive disease in AAs (OR ¼ 3.90, 95% CI ¼ 1.97-7.75). WHR > 0.98 among all research subjects adjusted for race was significantly associated with high aggressive prostate cancer (OR ¼ 1.42, 95% CI ¼ 1.00-2.00) when compared with WHR < 0.90. The stratified result is less clear among AAs.Conclusions: This study shows a positive association between obesity and aggressive prostate cancer. AAs have more aggressive prostate cancer in general than CAs even at normal weight. Therefore, the association between obesity and aggressiveness is not as evident in AAs as in CAs.Impact: This study provides a unique opportunity to examine impact of race on obesity and high aggressive prostate cancer relationship. Cancer Epidemiol Biomarkers Prev; 20(5); 844-53. Ó2011 AACR.

Obesity, Diabetes Mellitus and Vascular Disease: A Complex Relationship with Prostate Cancer

“…In our study, similarly to recent literature, we found that obesity was significantly associated with increased high-grade PCa [1]- [3]. Particularly, men had a greater than 2-fold increased risk of high-grade disease, compared with non-obese men.…”

Central Adiposity and Prostate Cancer in a Black Population

“…Similarly, the North Carolina-Louisiana Prostate Cancer Project, which included 1,049 African-American men and 1,083 Caucasian-American males, found that (overall) men with a WHR > 0.98 (compared with those with a WHR < 0.90) had an increased risk of highly aggressive disease (OR, 1.42; 95% CI, 1.00-2.00; ref. 13). However, when the data were stratified by race, the results showed that larger WHR (taken at the time of interview) was not related to prostate cancer risk in men of African origin (OR, 1.18; 95% CI, 0.76-1.83) but was significantly associated with aggressive cancer in men of European descent (OR, 2.03; 95% CI, 1.10-3.74).…”

“…The findings from these studies have been inconsistent, with higher waist circumference implicated as increasing total prostate cancer risk in one study of African-American men in Michigan (12) but not another including men from Jamaica (11). The Jamaican study, however, reported that larger WHRs increased risk among high grade and all prostate cancer cases, whereas race-stratified data from a study in North Carolina did not corroborate these findings (13). The role of abdominal obesity on prostate cancer risk thus remains unclear, particularly among men of African descent.…”

“…Several studies have indicated that WHR does not influence the development of prostate cancer (8, 9, 15, 16, 19 22, 23, 24), whereas others report a significant positive association (11,13,17,21). Although some investigations support the relationship between higher WHR measurements and increased prostate cancer risk regardless of disease severity, the association has been shown to be stronger among those with advanced, high-grade disease (13,17).…”

Metabolic Syndrome and Prevalent Any-site, Prostate, Breast and Colon Cancers in the U.S. Adult Population: NHANES 1999-2010

“…Differences in blood glucose level (i.e., high glucose (≥5.6 mM) vs. diabetes (≥11.1 mM)) may have exaggerated these differences, as only 22 of 204 prostate cancer cases had physician diagnosed diabetes in our study. Given the central role of obesity in MetS and its high prevalence in the US population, it is also possible that duration of obesity (or elevated blood glucose) may be an important factor in prostate cancer development through oxidative stress induced cell proliferation, reduced adiponectin levels, and hyperinsulinemia induced prostate/ colon cancer cell proliferation [3,4,32,33]. When taken together, the discrepancy between the findings may be due to variation in: i) confounding variables and sample (i.e.…”